By Kierra Jones
Nursing students working toward program changes
The Canadian Nursing Students’ Association believes focus on global health and the LGBTQ+ community should be prioritized and standardized in nursing school curricula
Increased emphasis on global health and the LGBTQ+ community are among the changes the Canadian Nursing Students’ Association (CNSA) would like to see in nursing education across Canada. This school year, the organization will undertake a variety of initiatives aimed at promoting curriculum and clinical placement standards that better reflect what students want.
A member of the Canadian Nurses Association, CNSA serves as the national voice of nearly 30,000 students.
At the organization’s National Assembly last January, delegates voted to support statements advocating greater inclusion of global health and LGBTQ+ patient needs in Canadian curriculum standards.
The initiative is CNSA’s first to focus on proposing curriculum changes, says president Caitlin Wiltshire. “The biggest thing is, we want to do it right. We want our changes to be, for global health, ethical and sustainable, and for LGBTQ+...sensible and sensitive.”
Knowledge of global health issues is an essential component for baccalaureate nursing programs in the National Nursing Education Framework developed by the Canadian Association of Schools of Nursing (CASN). However, quality, design and delivery of global health content and international placements differ among institutions. According to a survey conducted by CNSA in 2016, more than 80 per cent of the respondents (from 26 member schools) reported being dissatisfied with academic global health opportunities available to them, including dedicated courses and courses containing global health content, international preceptorships and exchange programs.
For example, explains CNSA’s global health committee chair Vigne Sridharan, some students would like to see more education about ethical issues that can arise during international placements, such as whether they should choose to follow cultural norms different from their own.
The organization plans to consult students and faculties to learn about global health opportunities at each member school, Sridharan says. From there, CNSA will create a proposal package students can present to their program’s curriculum development committee, outlining why greater inclusion of global health perspectives is needed.
“Global health is not just about volunteering in community development in a remote area for two weeks,” she says. “It is an academic discipline that needs to be effectively designed, implemented and evaluated.” Sridharan emphasizes that learning about global health is essential in helping future nurses provide culturally competent care and address health inequities.
The health-care needs of LGBTQ+ patients are also not consistently addressed in nursing curricula, says Jayden Meville, CNSA diversity committee chair.
According to Meville, individual institutions do make efforts to incorporate LGBTQ+ content through presentations and student-led discussions. However, most of the education about LGBTQ+ health-care issues is carried out by activist students and pride organizations on campus.
“The goal is not to make each nurse an expert in LGBTQ+ health care but to make our nurses aware of the inequities that [this community] faces in health care, so that we can be proper allies and create safe spaces for our patients.”
Use of appropriate language is a particular issue. Meville gives the example of seeing the term biological female gender used on an exam. She explains that gender is a cultural or personal expression, and sex refers to biological characteristics, so using biological and gender in the same term is incorrect. “A standardized curriculum model should require the incorporation of LGBTQ+ topics, such as the history of the oppression of LGBTQ+ people and LGBTQ+ health care across the lifespan, into core nursing classes, simulations and labs,” she adds.
CNSA will work with students, faculties and interest groups to determine potential entry-to-practice competencies in both areas. The long-term objective is to present proposals to CASN’s standing committee on education, says Wiltshire.
CASN and CNSA have worked together closely on multiple projects. For instance, CASN has supported CNSA’s push to resolve issues around the NCLEX-RN entry-to-practice exam, including concerns about the exam’s French translation. “CASN supported our letter-writing initiative and posted information about this campaign on its website,” Wiltshire says.
CASN executive director Cynthia Baker sits on the CNSA board. She holds that CNSA “plays an important national role in bringing students’ perspectives to the profession.”
Her association has already integrated some of CNSA’s focus areas into national guidelines.
CASN is about to release entry-to-practice competencies for maternal and newborn nursing. The competencies address the needs of the LGBTQ+ community, and the term childbearing person rather than childbearing woman is used throughout the document, explains Baker.
Also planned is the release of competencies for gerontological nursing and guidelines to help educators integrate discussions about Canada’s opioid crisis into their curricula.
In addition to proposing curriculum changes, CNSA also aims to raise awareness about why attending professional development events, such as its annual conference, should be counted as clinical hours. According to Wiltshire, the organization wants to provide students with a self-evaluation tool to help explain to faculty that participating in meetings and other events can align with some of the entry-to-practice competencies.
Another CNSA focus is to work with groups nationwide to determine actions nursing schools can take to accommodate people with disabilities in clinical placements, such as adopting amplified stethoscopes, she says.
Through a national needs assessment and stakeholder interviews that will identify adaptive technology options and helpful strategies, CNSA will create a toolkit with specific ideas for accommodation. Wiltshire explains that the objective is to provide a jumping-off point for schools and faculties that have accommodation as their goal but don’t know where to start.
More information on CNSA’s initiatives is available at cnsa.ca.